Are people with lighter skin more prone to getting skin cancer?

Skin cancer is a significant health concern that affects people of all ethnicities. However, research has consistently shown that fair-skinned (white) individuals and those with albinism are more susceptible to developing skin cancer compared to their dark-skinned counterparts with higher melanin levels.

In this article, we explore the reasons behind this heightened risk and look at how one can protect themselves from the negative effects of sunlight. 

The causes of skin cancer cut across all skin tones. These include, prolonged exposure to ultraviolet (UV) radiation from the sun, (spending long hours in the scorching sun), skin pigmentation, genetic factors and family history, which plays a role in skin cancer risk, regardless of pigmentation. Underlying conditions that weaken the immune system also increase one’s susceptibility to skin cancer.                    

According to the Centres for Disease Control and Prevention (CDC), most skin cancers are caused by too much exposure to solar ultraviolet (UV) rays. These rays damage the cells in the skin, causing them to mutate which in turn causes skin cancer.      

The risk for fair-skinned individuals 

A big factor in skin cancer risk is skin pigmentation, scientifically known as melanin. Melanin, the pigment responsible for the colour of one’s skin, hair and eyes, plays a crucial role in protecting the skin from the harmful effects of the sun's harmful UV rays. It is like a natural sunscreen. 

Dr Alex Bakenga, an oncologist at the Uganda Cancer Institute, says dark-skinned individuals are less likely to suffer from skin cancer due to having higher levels of melanin. 

The melanin acts as a natural sunblock, absorbing and dissipating UV rays before they can damage the DNA in skin cells. Fair-skinned individuals (such as Caucasians, Asians and Albinos) on the other hand, have lower levels of melanin, making them more susceptible to the harmful effects of UV radiation and skin cancer.  

“Melanin is produced by the skin cells called melanocytes. All human beings have the same number of melanocytes, although the amount of melanin produced by these melanocytes varies. The melanocytes in the skin of Caucasians and Albinos do not produce as much melanin as those in dark-skinned individuals,” Dr Bakenga says.

He notes that fair-skinned individuals are more prone to skin cancers caused by the sun’s UV rays. These include Basal Cell Carcinoma (BCC), which is the most common type of skin cancer and is often associated with sun exposure. Squamous Cell Carcinoma (SCC) another form of skin cancer also linked to sun exposure and is more prevalent in individuals with fair skin. These cancers will most likely appear on areas on the body that are frequently exposed to the sun, such as the face, neck, ears and hands.    

“The most prevalent type of skin cancer in Uganda is Epidemic Kaposi Sarcoma, which typically affects people with compromised immune systems, due to an underlying health conditions.  It is not linked to sun exposure. It is common among patients, with HIV/Aids since HIV is the biggest risk factor for Sarcoma,” Dr Bakenga explains.            

Protecting yourself from harmful UV rays

While dark skin provides some natural protection, it does not eliminate the risk of skin cancer entirely. The simplest and most affordable way to protect yourself from UV rays is wearing clothing that covers as much of your body as possible while out in the sun for long hours. You can also wear sunglasses and a hat. These physical barriers help stop most of the solar UV rays from reaching your skin.

Also, light-coloured clothing offers less sun protection than darker colours, which absorb more solar UV radiation.                   

Sunscreen

Sunscreen is the next line of protection, most especially for areas of your body that are most exposed to the sun such your face, ears, and the tops of the feet. Sunscreen works by either absorbing, reflecting, or scattering UV radiation, reducing the amount that reaches the skin.      

It is a must for people with white skin, Asians, albinos, to wear screen. The need for a dark skinned person to wear, sunscreen, Dr Bakenga says, is dependent on how much time they spend in the sun.           

“If the nature of your job keeps you inside a building for most of the day, then you can do without sunscreen. However, someone who works outside in the sun the whole day must wear sunscreen. However, since sunscreen is costly, one can reduce their risk by wearing a hat or sitting under an umbrella” Dr Bakenga says.  

Apart from protecting your skin from UV radiation, sunscreen prevents hyperpigmentation of the skin. The body parts exposed to the sun are usually darker in complexion.  

Sunscreen helps prevent sun-induced hyperpigmentation, which can lead to uneven skin tone. Sunscreen also protects the skin against premature aging since UV radiation can accelerate the aging process, leading to wrinkles and fine lines. Sunscreen helps maintain youthful skin by minimising sun damage. 

If you prefer to use sunscreen on a daily basis, use sunscreen with the highest sun protection factor (SPF) such as SPF 50. You can also seek some guidance from a dermatologist on what SPF is effective. 

It should be noted that sunlight has various benefits that can improve your health and well-being. Therefore, exposure to some sun can help your body make vitamin D, which helps keep bones, teeth and muscles healthy. 

It also produces the feel good hormone called serotonin, which can help improve one’s memory and help them get a good night’s sleep.